The most controversial check I write each year is the one that goes to a small nonprofit called Project Prevention. Project Prevention pays drug addicts and chronic alcoholics to get permanent or long term birth control. Director Barbara Harris founded the program after adopting not one or two but four drug addicted babies from the same mother. She watched them scream and writhe inconsolably, backs arched and hands clenched, and she said, "Enough."

Reproductive rights organizations that I support like Planned Parenthood and NARAL don’t approve of Barbara’s work. It operates in a bioethical gray zone that makes them uncomfortable, and should. Here is their reasoning: Payment has the power to manipulate people into decisions they will regret. An addict may be desperate enough for a fix that she’d sell her soul, let alone her ability to reproduce.

I think they are right. Addiction does make people that desperate, and a decision born of desperation is a decision coerced. Consequently, addiction pits two things I cherish against each other. One of them is reproductive freedom. I believe passionately that parenthood is one of the richest, most spiritual dimensions of life, and that we collectively should neither obligate nor restrict it without overwhelming cause.

I also believe is that childhood is a precious trust, and we should bring children into this world only if we are prepared to honor that trust–to give them a decent shot at flourishing. Under the wrong circumstances childhood can be a living hell. And that is far more likely to be the case when children are the unintended product of unprotected sex, with the judgment of involved parties clouded by addiction.

When our ancestors had no control over fertility, childbearing wasn’t a moral decision. But now it is. I tell my children that we are responsible for what we have control over; power and responsibility are two sides of the same coin. Contraception is one of humanity’s newfound powers. So it is that contraceptives bring a new dimension of moral decision making to the human race. And as someone who has influence over another person’s reproductive decisions through my charitable giving, I end up having to weigh moral questions.

In my experience, we encounter moral dilemmas most often when two good things or two bad things are pitted against each other. It’s easy to say that childhood health is a good thing or to say that personal freedom is a good thing. But which matters more– the freedom of women to reproduce as they choose, or the right of children to have a healthy start in life?

As a woman, I am utterly grateful that my culture, U.S. Laws, scientific advances and financial privilege gave me a high level of reproductive freedom. I had the freedom to defer childbearing– to go to school, travel, and heal my childhood wounds first. I had the freedom to abort an unhealthy fetus. I had the freedom, finally, to bring two chosen daughters into a solid marriage with a bounty of love and life experiences to share. When I think of my own life, I value reproductive freedom a lot: for people I love like my daughters, but also for people I’ve never met.

But is it the needs of women or children that go most to the core for me? Mercifully, they often are aligned. Still, how do I weigh them when they come into conflict?

One way I get insight into my own hierarchy of values is by looking at what I do. Throughout my adult life, my most compelling efforts (grad school, work, volunteering, giving, writing) have been about making room for a little more delight and a little less pain in this world. To me, more reproductive freedom and fewer addicted babies both matter because they serve this end. But if I look closely at my own history, one of these values trumps the other. The lettering I painstakingly stuck on my car as a young therapist said, "Children deserve to be planned for and chosen." Years later, I was instantly smitten with a quirky warm political co-conspirator, Patricia, who declared that she was pro-choice because, "All babies deserve to have their toes kissed."

My checks to Project Prevention fit a pattern. They tell me that over all these years, my values–in this area, at least–haven’t changed. All babies do deserve to have their toes kissed, and their knees and elbows and unclenched hands. It is a bonus that, from the sound of things, most of Project Prevention’s efforts–inspired by Barbara’s babies–are giving women healthy (new) beginnings in life too.